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Ruano-Ravina A, Martin-Gisbert L, Kelsey K, Pérez-Ríos M, Candal-Pedreira C, Rey-Brandariz J, Varela-Lema L. An overview on the relationship between residential radon and lung cancer: what we know and future research. Clin Transl Oncol 2023; 25:3357-3368. [PMID: 37610496 PMCID: PMC10603006 DOI: 10.1007/s12094-023-03308-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 08/24/2023]
Abstract
We aim to provide an overview of the research available on indoor radon and lung cancer, with a special focus on Spanish investigations. Early studies on underground miners established the link between radon and lung cancer, which was later confirmed for the general population by residential case-control studies. Spain contributed with extensive evidence, including 5 multicentric, hospital-based, case-control studies in the last 30 years, exploring diverse aspects, such as radon's effect on never-smokers, molecular pathways linking radon exposure to lung cancer risk, survival rates, mortality burden, and occupational exposure. There is a well-established causal association between radon with lung cancer. Despite pioneering research performed in our country by the Galician Radon Laboratory, particularly on driver genes, the evidence on the potential molecular pathways which makes radon a carcinogen is sparse. Also, relevant questions on the potential association of radon exposure with the induction of other diseases are still pending.
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Affiliation(s)
- Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, Facultade de Medicina, University of Santiago de Compostela, Rua San Francisco S/N, 15782, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública/CIBERESP), Madrid, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela-IDIS), Santiago de Compostela, Spain
- Cross-Disciplinary Research in Environmental Technologies (CRETUS), University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Lucia Martin-Gisbert
- Department of Preventive Medicine and Public Health, Facultade de Medicina, University of Santiago de Compostela, Rua San Francisco S/N, 15782, Santiago de Compostela, Spain.
- Cross-Disciplinary Research in Environmental Technologies (CRETUS), University of Santiago de Compostela, Santiago de Compostela, Spain.
| | - Karl Kelsey
- Department of Epidemiology, Brown School of Public Health, Brown University, Providence, RI, USA
| | - Mónica Pérez-Ríos
- Department of Preventive Medicine and Public Health, Facultade de Medicina, University of Santiago de Compostela, Rua San Francisco S/N, 15782, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública/CIBERESP), Madrid, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela-IDIS), Santiago de Compostela, Spain
| | - Cristina Candal-Pedreira
- Department of Preventive Medicine and Public Health, Facultade de Medicina, University of Santiago de Compostela, Rua San Francisco S/N, 15782, Santiago de Compostela, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela-IDIS), Santiago de Compostela, Spain
- Cross-Disciplinary Research in Environmental Technologies (CRETUS), University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Julia Rey-Brandariz
- Department of Preventive Medicine and Public Health, Facultade de Medicina, University of Santiago de Compostela, Rua San Francisco S/N, 15782, Santiago de Compostela, Spain
- Cross-Disciplinary Research in Environmental Technologies (CRETUS), University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Leonor Varela-Lema
- Department of Preventive Medicine and Public Health, Facultade de Medicina, University of Santiago de Compostela, Rua San Francisco S/N, 15782, Santiago de Compostela, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública/CIBERESP), Madrid, Spain
- Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela-IDIS), Santiago de Compostela, Spain
- Cross-Disciplinary Research in Environmental Technologies (CRETUS), University of Santiago de Compostela, Santiago de Compostela, Spain
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2
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Kelly-Reif K, Bertke SJ, Rage E, Demers PA, Fenske N, Deffner V, Kreuzer M, Samet J, Schubauer-Berigan MK, Tomasek L, Zablotska LB, Wiggins C, Laurier D, Richardson DB. Radon and lung cancer in the pooled uranium miners analysis (PUMA): highly exposed early miners and all miners. Occup Environ Med 2023; 80:385-391. [PMID: 37164624 PMCID: PMC10369304 DOI: 10.1136/oemed-2022-108532] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 04/20/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVES Radon is a ubiquitous occupational and environmental lung carcinogen. We aim to quantify the association between radon progeny and lung cancer mortality in the largest and most up-to-date pooled study of uranium miners. METHODS The pooled uranium miners analysis combines 7 cohorts of male uranium miners with 7754 lung cancer deaths and 4.3 million person-years of follow-up. Vital status and lung cancer deaths were ascertained between 1946 and 2014. The association between cumulative radon exposure in working level months (WLM) and lung cancer was modelled as the excess relative rate (ERR) per 100 WLM using Poisson regression; variation in the association by temporal and exposure factors was examined. We also examined analyses restricted to miners first hired before 1960 and with <100 WLM cumulative exposure. RESULTS In a model that allows for variation by attained age, time since exposure and annual exposure rate, the ERR/100 WLM was 4.68 (95% CI 2.88 to 6.96) among miners who were less than 55 years of age and were exposed in the prior 5 to <15 years at annual exposure rates of <0.5 WL. This association decreased with older attained age, longer time since exposure and higher annual exposure rate. In analyses restricted to men first hired before 1960, we observed similar patterns of association but a slightly lower estimate of the ERR/100 WLM. CONCLUSIONS This new large, pooled study confirms and supports a linear exposure-response relationship between cumulative radon exposure and lung cancer mortality which is jointly modified by temporal and exposure factors.
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Affiliation(s)
- Kaitlin Kelly-Reif
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
| | - Stephen J Bertke
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
| | - Estelle Rage
- Institute for Radiological Protection and Nuclear Safety, Fontenay-aux-Roses, France
| | - Paul A Demers
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Nora Fenske
- Federal Office for Radiation Protection (BfS), Munich (Neuherberg), Germany
| | - Veronika Deffner
- Federal Office for Radiation Protection (BfS), Munich (Neuherberg), Germany
| | - Michaela Kreuzer
- Federal Office for Radiation Protection (BfS), Munich (Neuherberg), Germany
| | | | - Mary K Schubauer-Berigan
- Evidence Synthesis and Classification Branch, International Agency for Research on Cancer, Lyon, France
| | | | - Lydia B Zablotska
- Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Charles Wiggins
- University of New Mexico, Albuquerque, New Mexico, USA
- New Mexico Tumor Registry, Albuquerque, Mexico, USA
| | - Dominique Laurier
- Institute for Radiological Protection and Nuclear Safety, Fontenay-aux-Roses, France
| | - David B Richardson
- Department of Environmental and Occupational Health, University of California, Irvine, Program in Public Health, Irvine, California, USA
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Madas BG, Boei J, Fenske N, Hofmann W, Mezquita L. Effects of spatial variation in dose delivery: what can we learn from radon-related lung cancer studies? RADIATION AND ENVIRONMENTAL BIOPHYSICS 2022; 61:561-577. [PMID: 36208308 PMCID: PMC9630403 DOI: 10.1007/s00411-022-00998-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 09/28/2022] [Indexed: 05/14/2023]
Abstract
Exposure to radon progeny results in heterogeneous dose distributions in many different spatial scales. The aim of this review is to provide an overview on the state of the art in epidemiology, clinical observations, cell biology, dosimetry, and modelling related to radon exposure and its association with lung cancer, along with priorities for future research. Particular attention is paid on the effects of spatial variation in dose delivery within the organs, a factor not considered in radiation protection. It is concluded that a multidisciplinary approach is required to improve risk assessment and mechanistic understanding of carcinogenesis related to radon exposure. To achieve these goals, important steps would be to clarify whether radon can cause other diseases than lung cancer, and to investigate radon-related health risks in children or persons at young ages. Also, a better understanding of the combined effects of radon and smoking is needed, which can be achieved by integrating epidemiological, clinical, pathological, and molecular oncology data to obtain a radon-associated signature. While in vitro models derived from primary human bronchial epithelial cells can help to identify new and corroborate existing biomarkers, they also allow to study the effects of heterogeneous dose distributions including the effects of locally high doses. These novel approaches can provide valuable input and validation data for mathematical models for risk assessment. These models can be applied to quantitatively translate the knowledge obtained from radon exposure to other exposures resulting in heterogeneous dose distributions within an organ to support radiation protection in general.
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Affiliation(s)
- Balázs G Madas
- Environmental Physics Department, Centre for Energy Research, Budapest, Hungary.
| | - Jan Boei
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Nora Fenske
- Federal Office for Radiation Protection, Munich (Neuherberg), Germany
| | - Werner Hofmann
- Biological Physics, Department of Chemistry and Physics of Materials, University of Salzburg, Salzburg, Austria
| | - Laura Mezquita
- Medical Oncology Department, Hospital Clinic of Barcelona, Barcelona, Spain
- Laboratory of Translational Genomic and Targeted Therapies in Solid Tumors, IDIBAPS, Barcelona, Spain
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Su Z, Jia XH, Fan YG, Zhao FH, Zhou QH, Taylor PR, Qiao YL. Quantitative evaluation of radon, tobacco use and lung cancer association in an occupational cohort with 27 follow-up years. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 232:113233. [PMID: 35093810 DOI: 10.1016/j.ecoenv.2022.113233] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Occupational radon cohorts provide important information about exposure at residential level, which are difficult to observe prospectively. However, evidence about radon-related lung cancer risks from initial exposure in childhood or interaction between radon and smoking is still limited. METHODS A total of 6017 tin miners with at least 10 years of underground radon exposure were enrolled beginning in 1992 and followed for up to 27 years. Lung cancer risks were estimated by modeling total and intensity of radon exposure. RESULTS A total of 933 lung cancer cases occurred in this cohort over 89,092 person-years of follow up. Excess relative risk increased by 0.96% per cumulative working level month (WLM). A unique aspect of this population was the early age at first radon exposure for workers. Results showed that lung cancer risk from initial radon exposure in childhood (<13 years old) was greater than risk when first exposure occurred at later ages (13-17, 18-24, and ≥ 25 years old). Moreover, risk declined with years since last exposure and attained age, but increased with age at last exposure. Importantly, these patterns were stable after adjustment for tobacco use or arsenic exposure. For joint effects of radon and other agents, our results support sub-multiplicative as the most likely model for interaction between radon and tobacco use or arsenic exposure. CONCLUSION This study highlights the possible importance of radon exposure in childhood in cancer etiology and suggests another potential strategy to mitigate the global lung cancer burden.
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Affiliation(s)
- Zheng Su
- Department of Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xin-Hua Jia
- Department of Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; The State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University, Xiamen, Fujian, China
| | - Ya-Guang Fan
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China.
| | - Fang-Hui Zhao
- Department of Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Qing-Hua Zhou
- Tianjin Key Laboratory of Lung Cancer Metastasis and Tumor Microenvironment, Tianjin Lung Cancer Institute, Tianjin Medical University General Hospital, Tianjin, China; Sichuan Lung Cancer Institute, Sichuan Lung Cancer Center, West China Hospital, Chengdu, Sichuan University, China
| | - Philip R Taylor
- Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - You-Lin Qiao
- Center for Global Health, School of Population Medicine and Public Health Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Abstract
Systematic bio- and databanks are key prerequisites for modern radiation research to investigate radiation response mechanisms in the context of genetic, environmental and lifestyle-associated factors. This report presents the current status of the German Uranium Miners’ Biobank. In 2008, the bio- and databank was established at the Federal Office for Radiation Protection, and the sampling of biological materials from former uranium miners with and without lung cancer was initiated. For this purpose, various biological specimens, such as DNA and RNA, were isolated from blood samples as well as from formalin-fixed paraffin-embedded lung tissue. High-quality biomaterials suitable for OMICs research and the associated data on occupational radiation and dust exposure, and medical and lifestyle data from over 1000 individuals have been stored so far. Various experimental data, e.g., genome-wide SNPs, whole genome transcriptomic and miRNA data, as well as individual chromosomal aberration data from subgroups of biobank samples, are already available upon request for in-depth research on radiation-induced long-term effects, individual radiation susceptibility to lung cancer and radon-induced fingerprints in lung cancer. This biobank is the first systematic uranium miners´ biobank worldwide that is suitable for OMICs research on radiation-exposed workers. It offers the opportunity to link radiation-induced perturbations of biological pathways or processes and putative adverse outcome(s) by OMICs profiling at different biological organization levels.
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Abstract
Fundamental estimates of radon-associated health risk have been provided by epidemiological studies of miners. In total, approximately 15 studies have been conducted worldwide since the 1960s. These results have contributed directly to radiological protection against radon. The present article summarises the main results, with a focus on analyses of miners exposed more recently, estimates of radon lifetime attributable risk, and interaction between radon and smoking. The potential for the upcoming Pooled Uranium Miner Analysis project to further improve our knowledge is discussed.
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Affiliation(s)
- D Laurier
- Institute for Radiological Protection and Nuclear Safety, 92262 Fontenay aux Roses Cedex, France; e-mail:
| | | | - E Rage
- Institute for Radiological Protection and Nuclear Safety, 92262 Fontenay aux Roses Cedex, France; e-mail:
| | - L Tomasek
- National Radiation Protection Institute, Czech Republic
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Harbron RW, Pasqual E. Ionising radiation as a risk factor for lymphoma: a review. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2020; 40:R151-R185. [PMID: 33017815 DOI: 10.1088/1361-6498/abbe37] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 10/05/2020] [Indexed: 06/11/2023]
Abstract
The ability of ionising radiation to induce lymphoma is unclear. Here, we present a narrative review of epidemiological evidence of the risk of lymphoma, including chronic lymphocytic leukaemia (CLL) and multiple myeloma (MM), among various exposed populations including atomic bombing survivors, industrial and medical radiation workers, and individuals exposed for medical purposes. Overall, there is a suggestion of a positive dose-dependent association between radiation exposure and lymphoma. The magnitude of this association is highly imprecise, however, with wide confidence intervals frequently including zero risk. External comparisons tend to show similar incidence and mortality rates to the general population. Currently, there is insufficient information on the impact of age at exposure, high versus low linear energy transfer radiation, external versus internal or acute versus chronic exposures. Associations are stronger for males than females, and stronger for non-Hodgkin lymphoma and MM than for Hodgkin lymphoma, while the risk of radiation-induced CLL may be non-existent. This broad grouping of diverse diseases could potentially obscure stronger associations for certain subtypes, each with a different cell of origin. Additionally, the classification of malignancies as leukaemia or lymphoma may result in similar diseases being analysed separately, while distinct diseases are analysed in the same category. Uncertainty in cell of origin means the appropriate organ for dose response analysis is unclear. Further uncertainties arise from potential confounding or bias due to infectious causes and immunosuppression. The potential interaction between radiation and other risk factors is unknown. Combined, these uncertainties make lymphoma perhaps the most challenging malignancy to study in radiation epidemiology.
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Affiliation(s)
- Richard W Harbron
- Population Health Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
- NIHR Health Protection Research Unit in Chemical and Radiation Threats and Hazards, Newcastle University, United Kingdom
- Barcelona Institute for Global Health, (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Elisa Pasqual
- Barcelona Institute for Global Health, (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
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8
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Aumalikova M, Bakhtin M, Кazymbet P, Zhumadilov К, Altaeva N, Ibrayeva D, Shishkina E. Site-specific concentration of uranium in urine of workers of the hydrometallurgical plant of Stepnogorsk mining and chemical combine. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2020; 59:703-710. [PMID: 32970165 DOI: 10.1007/s00411-020-00874-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 09/19/2020] [Indexed: 06/11/2023]
Abstract
Radiation monitoring is an important radiation safety measure implemented at the hydrometallurgical plant of the Stepnogorsk mining and chemical combine (HMP SMCC, Republic of Kazakhstan). Follow-up of the workers and their regular medical examinations has laid the basis to create a cohort with the potential to be used in radiation epidemiology. The aim of current pilot study was to analyze the dose forming factors for workers of HMP SMCC. For this, bioassays samples collected from 54 workers employed at eight HMP workshops were measured using the "Agilent 7800 ICP-MS" mass spectrometer. Three years later, measurements were repeated for four workers with the highest concentrations of uranium in urine. The results of site-specific measurements of dose rates, long-lived alpha-particle activity concentrations and equivalent equilibrium volume activity of radon were derived from the archive of the HMP SMCC Service of Radiation and Toxic Safety and analyzed to fully evaluate the radiation situation at those workplaces. Maximum urine uranium concentrations were measured for workers at the extraction workshop and mechanical repair shop (up to 26.7 µg/L and 14.6 µg/L, respectively). Urinary uranium from workers employed at other sites was mainly (for about 72% of the samples) in the range of values that may occur in natural conditions (< 0.4 µg/L). A wide individual variability in uranium concentration in urine samples (from 60% to 200% of CV) was found. A linear dependence of cumulative effective dose on work experience was found with a slope of 7.5 mSv per year. This slope did not depend on working place. For the investigated workers, cumulative effective doses of workers were found in the range of low (< 100 mSv) and medium doses (100-500 mSv). It is concluded that the newly created cohort of HMP SMCC workers has the potential to improve the knowledge on health effects from low- and medium doses of ionizing radiation.
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Affiliation(s)
- Moldir Aumalikova
- L. N. Gumilyov Eurasian National University, Munaitpasova Str. 13, 010008, Nur-Sultan, Kazakhstan.
- Institute of Radiobiology and Radiation Protection NJSC "Astana Medical University", Beibitshilik Str. 49, 010000, Nur-Sultan, Kazakhstan.
| | - Meirat Bakhtin
- Institute of Radiobiology and Radiation Protection NJSC "Astana Medical University", Beibitshilik Str. 49, 010000, Nur-Sultan, Kazakhstan
| | - Polat Кazymbet
- Institute of Radiobiology and Radiation Protection NJSC "Astana Medical University", Beibitshilik Str. 49, 010000, Nur-Sultan, Kazakhstan
| | - Кassym Zhumadilov
- L. N. Gumilyov Eurasian National University, Munaitpasova Str. 13, 010008, Nur-Sultan, Kazakhstan
| | - Nursulu Altaeva
- Department of Molecular Biology, Histology, Cytology and Genetics NJSC "Astana Medical University", Beibitshilik Str. 49, 010000, Nur-Sultan, Kazakhstan
| | - Danara Ibrayeva
- L. N. Gumilyov Eurasian National University, Munaitpasova Str. 13, 010008, Nur-Sultan, Kazakhstan
- Institute of Radiobiology and Radiation Protection NJSC "Astana Medical University", Beibitshilik Str. 49, 010000, Nur-Sultan, Kazakhstan
| | - Elena Shishkina
- Ural Research Center for Radiation Medicine, Vorovsky Str. 68A, 454076, Chelyabinsk, Russia
- Chelyabinsk State University, Bratiev Kashirinykh St 129, 454001, Chelyabinsk, Russia
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Semenova Y, Pivina L, Zhunussov Y, Zhanaspayev M, Chirumbolo S, Muzdubayeva Z, Bjørklund G. Radiation-related health hazards to uranium miners. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:34808-34822. [PMID: 32638305 DOI: 10.1007/s11356-020-09590-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 06/03/2020] [Indexed: 06/11/2023]
Abstract
Concerns on health effects from uranium (U) mining still represent a major issue of debate. Any typology of active job in U mines is associated with exposure to U and its decay products, such as radon (Rn), thorium (Th), and radium (Ra) and its decay products with alpha-emission and gamma radiation. Health effects in U miners have been investigated in several cohort studies in the USA, Canada, Germany, the Czech Republic, and France. While public opinion is particularly addressed to pay attention to the safety of nuclear facilities, health hazard associated with mining is poorly debated. According to the many findings from cohort studies, the most significant positive dose-response relationship was found between occupational U exposure and lung cancer. Other types of tumors associated with occupational U exposure are leukemia and lymphoid cancers. Furthermore, it was found increased but not statistically significant death risk in U miners due to cancers in the liver, stomach, and kidneys. So far, there has not been found a significant association between U exposure and increased cardiovascular mortality in U miners. This review tries to address the current state of the art of these studies.
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Affiliation(s)
- Yuliya Semenova
- Semey Medical University, Semey, Kazakhstan
- CONEM Kazakhstan Environmental Health and Safety Research Group, Semey Medical University, Semey, Kazakhstan
| | - Lyudmila Pivina
- Semey Medical University, Semey, Kazakhstan
- CONEM Kazakhstan Environmental Health and Safety Research Group, Semey Medical University, Semey, Kazakhstan
| | | | | | - Salvatore Chirumbolo
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
- CONEM Scientific, Verona, Italy
| | | | - Geir Bjørklund
- Council for Nutritional and Environmental Medicine (CONEM), Toften 24, 8610, Mo i Rana, Norway.
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Bersimbaev R, Pulliero A, Bulgakova O, Asia K, Aripova A, Izzotti A. Radon Biomonitoring and microRNA in Lung Cancer. Int J Mol Sci 2020; 21:E2154. [PMID: 32245099 PMCID: PMC7139524 DOI: 10.3390/ijms21062154] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 03/18/2020] [Accepted: 03/18/2020] [Indexed: 12/17/2022] Open
Abstract
Radon is the number one cause of lung cancer in non-smokers. microRNA expression in human bronchial epithelium cells is altered by radon, with particular reference to upregulation of miR-16, miR-15, miR-23, miR-19, miR-125, and downregulation of let-7, miR-194, miR-373, miR-124, miR-146, miR-369, and miR-652. These alterations alter cell cycle, oxidative stress, inflammation, oncogene suppression, and malignant transformation. Also DNA methylation is altered as a consequence of miR-29 modification induced by radon. Indeed miR-29 targets DNA methyltransferases causing inhibition of CpG sites methylation. Massive microRNA dysregulation occurs in the lung due to radon expose and is functionally related with the resulting lung damage. However, in humans this massive lung microRNA alterations only barely reflect onto blood microRNAs. Indeed, blood miR-19 was not found altered in radon-exposed subjects. Thus, microRNAs are massively dysregulated in experimental models of radon lung carcinogenesis. In humans these events are initially adaptive being aimed at inhibiting neoplastic transformation. Only in case of long-term exposure to radon, microRNA alterations lead towards cancer development. Accordingly, it is difficult in human to establish a microRNA signature reflecting radon exposure. Additional studies are required to understand the role of microRNAs in pathogenesis of radon-induced lung cancer.
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Affiliation(s)
- Rakhmet Bersimbaev
- Department of General Biology and Genomics, Institute of Cell Biology and Biotechnology, L.N.Gumilyov Eurasian National University, Nur-Sultan, Akmola 010008, Kazakhstan; (R.B.); (O.B.); (K.A.); (A.A.)
| | - Alessandra Pulliero
- Department of Experimental Medicine, University of Genoa, I-16132 Genoa, Italy;
| | - Olga Bulgakova
- Department of General Biology and Genomics, Institute of Cell Biology and Biotechnology, L.N.Gumilyov Eurasian National University, Nur-Sultan, Akmola 010008, Kazakhstan; (R.B.); (O.B.); (K.A.); (A.A.)
| | - Kussainova Asia
- Department of General Biology and Genomics, Institute of Cell Biology and Biotechnology, L.N.Gumilyov Eurasian National University, Nur-Sultan, Akmola 010008, Kazakhstan; (R.B.); (O.B.); (K.A.); (A.A.)
| | - Akmara Aripova
- Department of General Biology and Genomics, Institute of Cell Biology and Biotechnology, L.N.Gumilyov Eurasian National University, Nur-Sultan, Akmola 010008, Kazakhstan; (R.B.); (O.B.); (K.A.); (A.A.)
| | - Alberto Izzotti
- Department of Experimental Medicine, University of Genoa, I-16132 Genoa, Italy;
- IRCCS Policlinico San Martino, 16132 Genoa, Italy
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11
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da Costa Dantas R, Navoni JA, de Alencar FLS, da Costa Xavier LA, do Amaral VS. Natural radioactivity in Brazil: a systematic review. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:143-157. [PMID: 31832968 DOI: 10.1007/s11356-019-06962-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 11/04/2019] [Indexed: 06/10/2023]
Abstract
Natural radioactivity is a public health concern worldwide. Its deleterious effects are largely associated with emitting ionizing particles which generate innumerable toxicological consequences to human being. The present study aimed to describe the research state of the art on natural radioactivity in Brazil through a systematic review limited to articles published in the twenty-first century in the PubMed, SciELO, Lilacs, and Google Scholar databases. A total of 55 research articles were considered for this purpose. Based on the collected sample types, the radiation analysis in most of the scientific reports was performed on solid samples (soil/sediment/rocks), followed by water and air. In fact, most of the available information came from geological studies. A wide range of concentrations and a variety of radionuclides have been assessed, with radium being the most cited. Most of the studies described radiation levels above the international guidelines, and consider the Brazilian territory as a high natural background radiation region (HNBR). In comparison with other HNBR areas, the scientific information about the related risks to human health is still scarce. There is uncertainty about the real impact of natural radioactivity on human health, as there is a lack of scientific information for most of the country about this issue. The analysis and comparison of the available information highlights the potential risks linked to natural radioactivity and the need to incorporate suitable environmental management policies about this issue.
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Affiliation(s)
- Richelly da Costa Dantas
- Rede Nordeste de Biotecnologia (RENORBIO), Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | - Julio Alejandro Navoni
- Programa de Pós-graduação em Desenvolvimento e Meio Ambiente (PRODEMA), Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
- Instituto Federal do Rio Grande do Norte (IFRN), Programa de Pós-graduação em Uso Sustentavel de Recursos Naturais (PPgUSRN), Natal, RN, Brazil
| | - Feliphe Lacerda Souza de Alencar
- Programa de Pós-graduação em Desenvolvimento e Meio Ambiente (PRODEMA), Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
- Departamento de Biologia Celular e Genética, Laboratório de Genética Toxicológica, Universidade Federal do Rio Grande do Norte, Sen. Salgado Filho, Lagoa Nova Natal, RN, CEP 59078-970, Brazil
| | - Luíza Araújo da Costa Xavier
- Departamento de Biologia Celular e Genética, Laboratório de Genética Toxicológica, Universidade Federal do Rio Grande do Norte, Sen. Salgado Filho, Lagoa Nova Natal, RN, CEP 59078-970, Brazil
- Programa de Pós-graduação em Bioquímica, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | - Viviane Souza do Amaral
- Rede Nordeste de Biotecnologia (RENORBIO), Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil.
- Programa de Pós-graduação em Desenvolvimento e Meio Ambiente (PRODEMA), Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil.
- Departamento de Biologia Celular e Genética, Laboratório de Genética Toxicológica, Universidade Federal do Rio Grande do Norte, Sen. Salgado Filho, Lagoa Nova Natal, RN, CEP 59078-970, Brazil.
- Programa de Pós-graduação em Bioquímica, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil.
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Aßenmacher M, Kaiser JC, Zaballa I, Gasparrini A, Küchenhoff H. Exposure-lag-response associations between lung cancer mortality and radon exposure in German uranium miners. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2019; 58:321-336. [PMID: 31218403 DOI: 10.1007/s00411-019-00800-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 06/05/2019] [Indexed: 06/09/2023]
Abstract
Exposure-lag-response associations shed light on the duration of pathogenesis for radiation-induced diseases. To investigate such relations for lung cancer mortality in the German uranium miners of the Wismut company, we apply distributed lag non-linear models (DLNMs) which offer a flexible description of the lagged risk response to protracted radon exposure. Exposure-lag functions are implemented with B-Splines in Cox models of proportional hazards. The DLNM approach yielded good agreement of exposure-lag-response surfaces for the German cohort and for the previously studied cohort of American Colorado miners. For both cohorts, a minimum lag of about 2 year for the onset of risk after first exposure explained the data well, but possibly with large uncertainty. Risk estimates from DLNMs were directly compared with estimates from both standard radio-epidemiological models and biologically based mechanistic models. For age > 45 year, all models predict decreasing estimates of the Excess Relative Risk (ERR). However, at younger age, marked differences appear as DLNMs exhibit ERR peaks, which are not detected by the other models. After comparing exposure-responses for biological processes in mechanistic risk models with exposure-responses for hazard ratios in DLNMs, we propose a typical period of 15 year for radon-related lung carcinogenesis. The period covers the onset of radiation-induced inflammation of lung tissue until cancer death. The DLNM framework provides a view on age-risk patterns supplemental to the standard radio-epidemiological approach and to biologically based modeling.
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Affiliation(s)
- Matthias Aßenmacher
- Department of Statistics, Ludwig-Maximilians-Universität, 80539, Munich, Germany.
| | - Jan Christian Kaiser
- Institute of Radiation Medicine, Helmholtz Zentrum München, 85764, Oberschleißheim, Germany
| | | | - Antonio Gasparrini
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, UK
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
- Centre for Statistical Methodology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Helmut Küchenhoff
- Department of Statistics, Ludwig-Maximilians-Universität, 80539, Munich, Germany
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Rump A, Eder S, Lamkowski A, Hermann C, Abend M, Port M. A quantitative comparison of the chemo- and radiotoxicity of uranium at different enrichment grades. Toxicol Lett 2019; 313:159-168. [PMID: 31276769 DOI: 10.1016/j.toxlet.2019.07.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 06/24/2019] [Accepted: 07/01/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The radiotoxic effects of uranium are often in the focus of the public fears but the chemical toxic effects of uranium are reported to surpass radiation effects. As there is no uranium isotope that is not radioactive, it is not possible to study chemical effects fully independently from radiation effects. In order to quantitate and compare radio- and chemotoxicity, we determined the median lethal doses of uranium due to its chemical toxicity and calculated the absorbed radiological doses resulting from the ingestion or inhalation of corresponding amounts depending on the isotopic enrichment grade. Committed effective doses over 50 years are related to the stochastic health effects like cancer occurrence and can be converted to a loss of statistical life time (mean loss 0.4 day / mSv). The equivalent doses absorbed within a short time frame permits conclusion on the induction of deterministic effects (e.g. acute radiation sickness). METHOD Simulations were based on the biokinetic models of the International Commission for Radioprotection and performed using Integrated Modules for Bioassay Analysis software. Results were compared with the doses given by the calculator of the WISE uranium project. The fractions of the total doses absorbed within different time periods were derived from the respective areas under the activity-time curves in the whole body. RESULTS The distribution of the total dose on the organs and tissues depends on the invasion pathway and the solubility of the compound. In the case of inhalation, the absorption of the total dose is more protracted than after ingestion. The incorporation of depleted or natural uranium in lethal amounts due to nephrotoxicity does not lead to deterministic radiation effects and is associated with committed effective doses reaching at most about 200 mSv (proposed possible threshold for therapeutic interventions after accidental radionuclide incorporation). The inhalation of low enriched uranium leads to higher effective doses up to 690 mSv, but they are still insufficient to cause acute deterministic effects. Even highly enriched uranium seems not to induce radiation nephropathy, but deterministic effects on the hematopoetic system cannot be excluded in particularly sensitive patients. But the equivalent doses to the lungs associated with the inhalation of poorly soluble compounds of highly enriched uranium are in a range that may induce radiation pneumonitis. CONCLUSION Our findings give clear evidence that for depleted and natural uranium chemical toxicity is much more marked than radiotoxicity. However, this conclusion must not be drawn for enriched and in particular highly enriched compounds that besides stochastic effects may even cause deterministic radiation effects.
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Affiliation(s)
- A Rump
- Bundeswehr Institute of Radiobiology, Munich, Germany.
| | - S Eder
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - A Lamkowski
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - C Hermann
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - M Abend
- Bundeswehr Institute of Radiobiology, Munich, Germany
| | - M Port
- Bundeswehr Institute of Radiobiology, Munich, Germany
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14
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Lane RSD, Tomášek L, Zablotska LB, Rage E, Momoli F, Little J. Low radon exposures and lung cancer risk: joint analysis of the Czech, French, and Beaverlodge cohorts of uranium miners. Int Arch Occup Environ Health 2019; 92:747-762. [PMID: 30737558 PMCID: PMC6556158 DOI: 10.1007/s00420-019-01411-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 01/23/2019] [Indexed: 12/05/2022]
Abstract
It is well established that high radon exposures increase the risk of lung cancer mortality. The effects of low occupational exposures and the factors that confound and modify this risk are not clear and are needed to inform current radiation protection of miners. The risk of lung cancer mortality at low radon exposures (< 100 working-level months) was assessed in the joint cohort analysis of Czech, French, and Canadian uranium miners, employed in 1953 or later. Statistical analysis was based on linear Poisson regression modeling with grouped cohort survival data. Two sensitivity analyses were used to assess potential confounding from tobacco smoking. A statistically significant linear relationship between radon exposure and lung cancer mortality was found. The excess relative risk per working-level month was 0.022 (95% confidence intervals: 0.013-0.034), based on 408 lung cancer deaths and 394,236 person-years of risk. Time since exposure was a statistically significant modifier; risk decreased with increasing time since exposure. A tendency for a decrease in risk with increasing attained age was observed, but this was not statistically significant. Exposure rate was not found to be a modifier of the excess relative risk. The potential confounding effect of tobacco smoking was estimated to be small and did not substantially change the radon-lung cancer mortality risk estimates. This joint cohort analysis provides strong evidence for an increased risk of lung cancer mortality from low occupational radon exposures. The results suggest that radiation protection measures continue to be important among current uranium miners.
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Affiliation(s)
- Rachel S. D. Lane
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Room 101, 600 Peter Morand Crescent, Ottawa, ON K1G 5Z3 Canada
- Directorate of Environmental and Radiation Protection and Assessment (DERPA), Canadian Nuclear Safety Commission (CNSC), 280 Slater Street, Station B, P.O. Box 1046, Ottawa, ON K1P 5S9 Canada
| | - Ladislav Tomášek
- National Radiation Protection Institute (SURO), Bartoskova 28, 140 00 Prague, Czech Republic
| | - Lydia B. Zablotska
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, 550 16th St, San Francisco, CA 94158 USA
| | - Estelle Rage
- Institute for Radiological Protection and Nuclear Safety, B.P. 17, 92262 Fontenay-aux-Roses Cedex, France
| | - Franco Momoli
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Room 101, 600 Peter Morand Crescent, Ottawa, ON K1G 5Z3 Canada
- Centre for Practice-Changing Research (Room L1152), Ottawa Hospital Research Institute, Children’s Hospital of Eastern Ontario Research Institute, 401 Smyth Rd, Ottawa, ON K1H 8L1 Canada
| | - Julian Little
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Room 101, 600 Peter Morand Crescent, Ottawa, ON K1G 5Z3 Canada
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15
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Abstract
PURPOSE OF REVIEW The incidence of pulmonary fibrosis is increasing worldwide and may, in part, be due to occupational and environmental exposures. Secondary fibrotic interstitial lung diseases may be mistaken for idiopathic pulmonary fibrosis with important implications for both disease management and prognosis. The purposes of this review are to shed light on possible underlying causes of interstitial pulmonary fibrosis and to encourage dialogue on the importance of acquiring a thorough patient history of occupational and environmental exposures. RECENT FINDINGS A recent appreciation for various occupational and environmental metals inducing both antigen-specific immune reactions in the lung and nonspecific "innate" immune system responses has emerged and with it a growing awareness of the potential hazards to the lung caused by low-level metal exposures. Advancements in the contrast and quality of high-resolution CT scans and identification of histopathological patterns of interstitial pulmonary fibrosis have improved clinical diagnostics. Moreover, recent findings indicate specific hotspots of pulmonary fibrosis within the USA. Increased prevalence of lung disease in these areas appears to be linked to occupational/environmental metal exposure and ethnic susceptibility/vulnerability. A systematic overview of possible occupational and environmental metals causing interstitial pulmonary fibrosis and a detailed evaluation of vulnerable/susceptible populations may facilitate a broader understanding of potential underlying causes and highlight risks of disease predisposition.
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Affiliation(s)
- Nour Assad
- Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM, 87131, USA
| | - Akshay Sood
- Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, NM, 87131, USA.,Miners' Colfax Medical Center, Raton, NM, 87740, USA
| | - Matthew J Campen
- Department of Pharmaceutical Sciences, University of New Mexico-Health Sciences Center, MSC09 5360, 1 University of New Mexico, Albuquerque, NM, 87131, USA
| | - Katherine E Zychowski
- Department of Pharmaceutical Sciences, University of New Mexico-Health Sciences Center, MSC09 5360, 1 University of New Mexico, Albuquerque, NM, 87131, USA.
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Walsh L, Schneider U, Fogtman A, Kausch C, McKenna-Lawlor S, Narici L, Ngo-Anh J, Reitz G, Sabatier L, Santin G, Sihver L, Straube U, Weber U, Durante M. Research plans in Europe for radiation health hazard assessment in exploratory space missions. LIFE SCIENCES IN SPACE RESEARCH 2019; 21:73-82. [PMID: 31101157 DOI: 10.1016/j.lssr.2019.04.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 04/09/2019] [Accepted: 04/11/2019] [Indexed: 05/04/2023]
Abstract
The European Space Agency (ESA) is currently expanding its efforts in identifying requirements and promoting research towards optimizing radiation protection of astronauts. Space agencies use common limits for tissue (deterministic) effects on the International Space Station. However, the agencies have in place different career radiation exposure limits (for stochastic effects) for astronauts in low-Earth orbit missions. Moreover, no specific limits for interplanetary missions are issued. Harmonization of risk models and dose limits for exploratory-class missions are now operational priorities, in view of the short-term plans for international exploratory-class human missions. The purpose of this paper is to report on the activity of the ESA Topical Team on space radiation research, whose task was to identify the most pertinent research requirements for improved space radiation protection and to develop a European space radiation risk model, to contribute to the efforts to reach international consensus on dose limits for deep space. The Topical Team recommended ESA to promote the development of a space radiation risk model based on European-specific expertise in: transport codes, radiobiological modelling, risk assessment, and uncertainty analysis. The model should provide cancer and non-cancer radiation risks for crews implementing exploratory missions. ESA should then support the International Commission on Radiological Protection to harmonize international models and dose limits in deep space, and guarantee continuous support in Europe for accelerator-based research configured to improve the models and develop risk mitigation strategies.
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Affiliation(s)
- L Walsh
- Department of Physics, Science Faculty, University of Zürich, Zurich, Switzerland
| | - U Schneider
- Department of Physics, Science Faculty, University of Zürich, Zurich, Switzerland
| | | | - C Kausch
- GSI Helmholtzzentrum für Schwerionenforschung, Biophysics Department, Darmstadt, Germany
| | | | - L Narici
- Department of Physics, University Tor Vergata, and INFN, Roma-2 Section, Rome, Italy
| | - J Ngo-Anh
- ESA-ESTEC, Nordwijk, the Netherlands
| | - G Reitz
- Nuclear Physics Institute, Czech Academy of Sciences, Prague, Czechia; Radiation Biology, Institue for Aerospace Medicine, DLR, Cologne, Germany
| | - L Sabatier
- Fundamental Research Division, D3P, CEA, Paris-Saclay, France
| | - G Santin
- ESA-ESTEC, Nordwijk, the Netherlands
| | - L Sihver
- Atominstitut, Technische Universität Wien, Wien, Austria; MedAustron, Wiener Neustadt, Austria
| | | | - U Weber
- GSI Helmholtzzentrum für Schwerionenforschung, Biophysics Department, Darmstadt, Germany
| | - M Durante
- GSI Helmholtzzentrum für Schwerionenforschung, Biophysics Department, Darmstadt, Germany; Technische Universität Darmstadt, Darmstadt, Germany.
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Helmig S, Lochnit G, Schneider J. Comparative proteomic analysis in serum of former uranium miners with and without radon induced squamous lung cancer. J Occup Med Toxicol 2019; 14:9. [PMID: 30923558 PMCID: PMC6419832 DOI: 10.1186/s12995-019-0228-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 02/26/2019] [Indexed: 11/10/2022] Open
Abstract
SUMMARY Former uranium miners of the Wismut Company, East Germany, have been exposed to ionizing radiation from radon decay products and therefore were at high risk for lung cancer. Since histological types of cancer in the so called Wismut cohort revealed an association of high radon exposure with a higher relative frequency of squamous cell carcinoma (SqCC), we used comparative proteomic analysis to identify differentially expressed proteins in serum exposed uranium miners with SqCC. METHODE Pooled sera of exposed former uranium miners without lung disease and pooled sera of former uranium miners with SqCC were analysed by 2-D gel electrophoresis. MALDI-TOF-MS was performed from reproducable, significantly, at least 5-fold up-regulated protein spots. Proteins were identified by MASCOT peptide mass fingerprint search. Additionally a receiver operating characteristic curve for CYFRA 21-1 was created. RESULTS The protein spots were identified as Keratin 10 (K10), Keratin 1 (K1), complement factor H (CFH) and a haptoglobin (Hpt) fragment. The sensitivity for CYFRA 21-1 reveals 60% at a specifity of 95 and 80% at a specifity of 80%. Plotting the sensitivity against specifity reveals an AUC of 0.88. CONCLUSION In SqCC Keratin 10 and 1 were strongly induced. This was associated with CYFRA 21-1, confirming the cytokeratin fragment as a tumormarker.
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Affiliation(s)
- Simone Helmig
- Institute and Outpatient Clinic for Occupational and Social Medicine, Justus-Liebig-University Giessen, Aulweg 129, D-35392, Giessen, Germany
| | - Günter Lochnit
- Institute of Biochemistry, Friedrichstraße 24, Justus-Liebig-University Giessen, D-35392, Giessen, Germany
| | - Joachim Schneider
- Institute and Outpatient Clinic for Occupational and Social Medicine, Justus-Liebig-University Giessen, Aulweg 129, D-35392, Giessen, Germany
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18
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Navaranjan G, Chambers D, Thompson PA, Do M, Berriault C, Villeneuve PJ, Demers PA. Uncertainties associated with assessing Ontario uranium miners' exposure to radon daughters. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2019; 39:136-149. [PMID: 30524032 DOI: 10.1088/1361-6498/aaf1eb] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The Ontario uranium miners study is a large (n = 28 546) cohort with low levels of radon exposure relative to other uranium miner cohorts. Multiple methods were used over time to estimate annual occupational exposure to radon daughters including: mine-specific extrapolations by mining engineers, area sampling in limited areas of the mines combined with approximate working time and lastly, consistent exposure sampling in different locations of the mine combined with workers' time cards. Nonetheless, estimating exposures involves assumptions that lead to some uncertainty in occupational exposure characterisation arising from the assessment approach and variability within workplace, over time and by individual. An evaluation of the total uncertainty associated with radon daughter exposure estimation in Ontario miners over time has not been conducted. The objective of this study was to identify the contributing sources and assess the total uncertainty associated with estimating occupational radon daughter exposure among underground Ontario uranium miners over the course of uranium mining. The five sources of radon daughter exposure uncertainty evaluated were: natural variations in radon concentration, estimation of working time, precision of the radon measurement method, unintended errors during sampling, and record keeping and transcription of exposure data. These sources were examined separately for the period 1958 to 1967 and then 1968 onward due to changes in radon daughter concentration measurement practices between these periods. The magnitude of uncertainty associated with each of these sources over time were determined by reviewing historical literature on uranium mining in Ontario as well as through expert advice. Using the root sum square method, the total radon daughter exposure uncertainty was found to be 53 to 67% in the earlier period of uranium mining from 1958 to 1967. This decreased to 31 to 39% for the period 1968 to 1996 with natural variations of radon daughter concentrations in mines accounting for the largest percentage of uncertainty. This assessment provides an initial step in understanding the effect of exposure uncertainty on risk estimates. The impact of this uncertainty on the dose-response relationship between radon exposure and cancer risk will be assessed in future work.
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Affiliation(s)
- Garthika Navaranjan
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada
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Malinovsky G, Yarmoshenko I, Vasilyev A. Meta-analysis of case-control studies on the relationship between lung cancer and indoor radon exposure. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2019; 58:39-47. [PMID: 30535840 DOI: 10.1007/s00411-018-0770-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 12/03/2018] [Indexed: 06/09/2023]
Abstract
Indoor exposure to natural radon is a factor that influences lung cancer risk worldwide. The present study includes a meta-analysis of epidemiological data on the relationship between lung cancer and indoor radon. Altogether, 31 case-control studies with 20,703 cases, 34,518 controls and 140 individual odds ratio (OR) estimates are included in the meta-analysis. Weighted median OR was calculated for five radon intervals. The following parameters were used for the weighting: standard error of OR, duration of radon concentration measurement, and relative number of controls in reference intervals. The dependence of the weighted median OR on the radon concentration was estimated applying linear non-threshold and threshold models. The results obtained suggest a significant linear no-threshold exposure-effect relationship for radon concentrations above 100 Bq/m3, with a slope of 0.14 (95% confidence interval 0.08-0.21) per 100 Bq/m3.
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Affiliation(s)
- Georgy Malinovsky
- Institute of Industrial Ecology UB RAS, 20, Sophy Kovalevskoy Str., Yekaterinburg, 620219, Russia.
| | - Ilia Yarmoshenko
- Institute of Industrial Ecology UB RAS, 20, Sophy Kovalevskoy Str., Yekaterinburg, 620219, Russia
| | - Aleksey Vasilyev
- Institute of Industrial Ecology UB RAS, 20, Sophy Kovalevskoy Str., Yekaterinburg, 620219, Russia
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Al Rashida VJM, Wang X, Myers OB, Boyce TW, Kocher E, Moreno M, Karr R, Ass'ad N, Cook LS, Sood A. Greater Odds for Angina in Uranium Miners Than Nonuranium Miners in New Mexico. J Occup Environ Med 2019; 61:1-7. [PMID: 30601436 PMCID: PMC6541557 DOI: 10.1097/jom.0000000000001482] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The aim of this study was to test the hypothesis that uranium miners in New Mexico (NM) have a greater prevalence of cardiovascular disease than miners who extracted the nonuranium ore. METHODS NM-based current and former uranium miners were compared with nonuranium miners by using cross-sectional standardized questionnaire data from the Mining Dust in the United States (MiDUS) study from 1989 to 2016. RESULTS Of the 7215 eligible miners, most were men (96.3%). Uranium miners (n = 3151, 43.7%) were older and diabetic, but less likely to currently smoke or use snuff (P ≤ 0.001 for all). After adjustment for covariates, uranium miners were more likely to report angina (odds ratio 1.51, 95% confidence interval 1.23 to 1.85) than nonuranium miners. CONCLUSION Our data suggest that along with screening for pulmonary diseases, uranium industry workers should be screened for cardiovascular diseases.
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Affiliation(s)
- Vanessa J M Al Rashida
- Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico (Drs al Rashida, Wang, Myers, Boyce, Kocher, Assad, Cook, Sood); Division of Cardiovascular Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas (Dr al Rashida); and Black Lung Program, Miners' Colfax Medical Center, Raton, New Mexico (Moreno, Karr, Dr Sood)
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Post-1971 Era Uranium Workers in New Mexico Have Significant Lung Disease Burden. Ann Am Thorac Soc 2018; 16:515-518. [PMID: 30525911 DOI: 10.1513/annalsats.201805-309rl] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Martins AC, Gallimberti M, de Oliveira Souza VC, Rocha BA, Barbosa F. Biomonitoring for uranium exposure among young children living in nineteen states across five regions of Brazil. J Radioanal Nucl Chem 2018. [DOI: 10.1007/s10967-018-5964-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Rage E, Caër-Lorho S, Laurier D. Low radon exposure and mortality among Jouac uranium miners: an update of the French cohort (1946-2007). JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2018; 38:92-108. [PMID: 28925920 DOI: 10.1088/1361-6498/aa8d97] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
After the extension of the French cohort of uranium miners with the inclusion of workers employed in the Jouac mines, this article seeks to describe the new Jouac cohort and to estimate mortality risks, as well as to quantify their relation to radon exposure in this extended cohort. The Jouac cohort includes 458 miners hired by the Société des Mines de Jouac between 1957 and 2001. There is no measurement of radon exposure before 1978 and so no data were available. Consequently, only the post-1977 Jouac cohort (n = 314) has been included in the French cohort, creating an extended cohort of 5400 French uranium miners followed up from 1946 to 2007. Mortality analyses computed the standardised mortality ratios (SMRs). Excess relative risks (ERRs) were assessed using Poisson regression models. No evidence of a significant excess risk of overall mortality (n = 66, SMR = 0.93; 95% CI = 0.72-1.19) or any specific mortality was observed in the Jouac cohort. In the extended cohort, overall mortality did not increase, but a significant excess of deaths was observed for all cancers (SMR = 1.11, 95% CI = 1.03-1.19), lung cancer (SMR = 1.32, 95% CI = 1.14-1.51), and kidney cancer (SMR = 1.58, 95% CI = 1.01-2.35). Cumulative exposure to radon was 3.9 working level month (WLM) and 35.1 WLM in the post-1977 Jouac and extended cohorts, respectively. Cumulative radon exposure was significantly associated with an excess risk of death from lung cancer (ERR/100 WLM = 0.73, 95% CI = 0.32-1.33) and from cerebrovascular diseases (ERR/100 WLM = 0.42 95% CI = 0.04-1.04). In conclusion, the Jouac cohort is still a young cohort and its inclusion leads to slight modifications compared to previous analyses of the French cohort. The already known relation between radon exposure and lung cancer death as well as the excess risk of death from cerebrovascular diseases persisted in the extended cohort.
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Affiliation(s)
- Estelle Rage
- Institute for Radiological Protection and Nuclear Safety (IRSN), PSE-SANTE, SESANE, LEPID, Fontenay-aux-Roses, France
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Sun Q, Mao W, Jiang H, Zhang X, Xiao J, Lian Y. The Effect of Protracted Exposure to Radiation on Liver Injury: A Cohort Study of Industrial Radiographers in Xinjiang, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E71. [PMID: 29300360 PMCID: PMC5800170 DOI: 10.3390/ijerph15010071] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 12/29/2017] [Accepted: 01/01/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND At present, a large number of studies indicate that high dose ionizing radiation exposure is an important risk factor for liver damage. Whether protracted exposure to low external doses of ionizing radiation could induce liver injury is unclear. The aim of this study was to assess the risk of liver injury following protracted exposure to occupational radiation compared to a group of unexposed workers. METHODS A three-year cohort study was initiated in Xinjiang, China in 2010 and included 508 industrial radiographers and 2156 unexposed workers. The incidence of liver injury was assessed clinically based on the evaluation of alanine aminotransferase (ALT) and aspartate transaminase (AST) levels. Logistic regression was used to examine whether radiation is a risk factor for liver injury. RESULTS Compared with the unexposed group, protracted radiation exposure was found to be a risk factor for liver injury. Sex, age at baseline and alcohol consumption were not associated with liver injury. However, hypertension was a risk factor for liver injury. The association between cumulative recorded radiation dose and liver injury was not found in this study. CONCLUSIONS These findings indicate that protracted exposure to radiation is a risk factor for liver injury.
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Affiliation(s)
- Qing Sun
- Division of Occupational and Environmental Health, College of Public Health, Nantong University, Se Yuan Road, No. 8, Nantong 226019, China.
| | - Weiming Mao
- Division of Occupational and Environmental Health, College of Public Health, Nantong University, Se Yuan Road, No. 8, Nantong 226019, China.
| | - Haiyue Jiang
- Division of Occupational and Environmental Health, College of Public Health, Nantong University, Se Yuan Road, No. 8, Nantong 226019, China.
| | - Xiaoyue Zhang
- Division of Occupational and Environmental Health, College of Public Health, Nantong University, Se Yuan Road, No. 8, Nantong 226019, China.
| | - Jing Xiao
- Division of Occupational and Environmental Health, College of Public Health, Nantong University, Se Yuan Road, No. 8, Nantong 226019, China.
| | - Yulong Lian
- Division of Occupational and Environmental Health, College of Public Health, Nantong University, Se Yuan Road, No. 8, Nantong 226019, China.
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Kreuzer M, Sobotzki C, Schnelzer M, Fenske N. Factors Modifying the Radon-Related Lung Cancer Risk at Low Exposures and Exposure Rates among German Uranium Miners. Radiat Res 2017; 189:165-176. [PMID: 29215327 DOI: 10.1667/rr14889.1] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
It is still not fully understood whether and how factors such as time, age and smoking modify the relationship between lung cancer and radon at low exposures and exposure rates. Improved knowledge is necessary for the dose conversion of radon in working level month (WLM) into effective dose, as currently discussed by the International Commission on Radiological Protection (ICRP). An update of the German uranium miner cohort study (n = 58,974 men) with a 10-year extension of mortality follow-up (1946-2013) was used to further examine this issue. Internal Poisson regression was applied to estimate the excess relative risk (ERR) for lung cancer mortality per unit of cumulative radon exposure in WLM with exponential time-related effect modifiers. In the full cohort restricted to <100 WLM the estimated overall ERR/WLM was 0.006 [95% confidence interval (CI): 0.003; 0.010] based on 1,254 lung cancer deaths and 1,620,190 person-years at risk. Both age at and time since exposure turned out to be important modifiers of the ERR/WLM and were included in the final model. Here, the ERR/WLM centered on age at exposure of 30 years, and 20 years since exposure was 0.016 (95% CI: 0.008; 0.028). This value decreased statistically significantly by approximately 40% and 60% for each 10-year increase in age at exposure and time since exposure, respectively. The joint effect of smoking and radon exposure was investigated in the sub-cohort of miners hired in 1960 or later, which includes data on smoking status. The centered ERR/WLM was slightly higher for non/light smokers compared to moderate/heavy smokers (0.022 versus 0.013). The current findings provide evidence for an increased lung cancer risk at low radon exposures or exposure rates that is modified by age and time. The observed risk is lower, but statistically compatible to those of other miner studies at low exposures or exposure rates. These findings reject an additive- and support a sub- to (supra-) multiplicative interaction between smoking and radon.
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Affiliation(s)
- M Kreuzer
- Federal Office for Radiation Protection, Department of Radiation Protection and Health, Neuherberg, Germany
| | - C Sobotzki
- Federal Office for Radiation Protection, Department of Radiation Protection and Health, Neuherberg, Germany
| | - M Schnelzer
- Federal Office for Radiation Protection, Department of Radiation Protection and Health, Neuherberg, Germany
| | - N Fenske
- Federal Office for Radiation Protection, Department of Radiation Protection and Health, Neuherberg, Germany
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Guéguen Y, Roy L, Hornhardt S, Badie C, Hall J, Baatout S, Pernot E, Tomasek L, Laurent O, Ebrahimian T, Ibanez C, Grison S, Kabacik S, Laurier D, Gomolka M. Biomarkers for Uranium Risk Assessment for the Development of the CURE (Concerted Uranium Research in Europe) Molecular Epidemiological Protocol. Radiat Res 2017; 187:107-127. [DOI: 10.1667/rr14505.1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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27
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Kreuzer M, Sobotzki C, Fenske N, Marsh JW, Schnelzer M. Leukaemia mortality and low-dose ionising radiation in the WISMUT uranium miner cohort (1946–2013). Occup Environ Med 2016; 74:252-258. [DOI: 10.1136/oemed-2016-103795] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 09/08/2016] [Accepted: 10/08/2016] [Indexed: 12/30/2022]
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Navaranjan G, Berriault C, Do M, Villeneuve PJ, Demers PA. Cancer incidence and mortality from exposure to radon progeny among Ontario uranium miners. Occup Environ Med 2016; 73:838-845. [PMID: 27651479 DOI: 10.1136/oemed-2016-103836] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 08/16/2016] [Accepted: 08/31/2016] [Indexed: 11/04/2022]
Abstract
OBJECTIVES The study objectives were to extend the follow-up of the Ontario uranium miners cohort, one of the largest cohorts of uranium miners with low cumulative exposures, to examine the relationship between radon exposure and lung cancer mortality and, for the first time incidence, and address gaps in the literature, including dose-response relationship between radon exposure and other cancer sites, and non-cancer mortality. METHODS The cohort of mine and mill workers was created using data from Canada's National Dose Registry and the Ontario Mining Master File. The follow-up for the cohort was recently extended for mortality (1954-2007) and for the first time includes cancer incidence (1969-2005). The Poisson regression was used to estimate relative risks (RR) and excess relative risks (ERR) and their 95% CIs with levels of cumulative radon exposure. RESULTS The cohort consisted of 28 546 male miners with a mean cumulative radon exposure of 21.0 working level months (WLM). An increased risk of lung cancer and a dose-response relationship was observed with cumulative radon exposure. Miners exposed to >100 WLM demonstrated a twofold increase in the risk of lung cancer incidence (RR=1.89, CI 1.43 to 2.50) compared with the non-exposed group, and a linear ERR of 0.64/100 WLM (CI 0.43 to 0.85), with similar results observed for mortality. No association was observed for other cancer sites (stomach, leukaemia, kidney and extrathoracic airways) or non-cancer sites (cardiovascular diseases) with increasing cumulative exposure to radon. CONCLUSIONS These findings suggest no increased risk of cancer sites other than lung or non-cancer mortality from relatively low cumulative exposure to radon.
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Affiliation(s)
- Garthika Navaranjan
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada
| | - Colin Berriault
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada
| | - Minh Do
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada
| | - Paul J Villeneuve
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada.,Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Paul A Demers
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Stammler L, Uhl A, Mayer B, Keller F. Renal Effects and Carcinogenicity of Occupational Exposure to Uranium: A Meta-Analysis. NEPHRON EXTRA 2016; 6:1-11. [PMID: 27275162 PMCID: PMC4886082 DOI: 10.1159/000442827] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
PURPOSE Uranium is a heavy metal with alpha radioactivity. We state the hypothesis that uranium exposure is harmful to human kidneys and carcinogenic to body tissues. Therefore, we review epidemiological studies from people with known long-lasting uranium exposure. MATERIALS AND METHODS Three meta-analyses are performed using clinical studies published in the PubMed database and applying RevMan 5.3 from the Cochrane Collaboration to calculate the outcome. The first two meta-analyses examine the standardized mortality ratio (SMR) and the standardized incidence ratio for any cancers of uranium workers who were operating in areas ranging from uranium processing to the assembly of final uranium products. The third meta-analysis evaluates the nephrotoxic risk in uranium workers as well as soldiers and of individuals with exposure to drinking water containing uranium. RESULTS Overall and contrasting to our hypothesis, the tumor risk is significantly lower for uranium workers than for control groups (SMR = 0.90 with a 95% confidence interval of 0.84 to 0.96). In addition and also contrasting to our hypothesis, the risk of nephrotoxicity is not increased either. This holds for both the incidence and the mortality due to renal cell carcinoma or due to acute kidney injury or chronic kidney disease. In contrast, a significantly better creatinine clearance is found for the uranium cohort as compared to the control groups (mean difference = 7.66 with a 95% confidence interval of 0.12 to 15.2). CONCLUSION Our hypothesis that a chronic uranium exposure is associated with an increased risk of cancer mortality or of kidney failure is refuted by clinical data. The decreased risk may result from better medical surveillance of uranium workers.
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Affiliation(s)
- Leonhard Stammler
- Nephrology, Department of Internal Medicine 1, Ulm University, Ulm, Germany
| | | | - Benjamin Mayer
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Frieder Keller
- Nephrology, Department of Internal Medicine 1, Ulm University, Ulm, Germany
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Sheen S, Lee KS, Chung WY, Nam S, Kang DR. An updated review of case-control studies of lung cancer and indoor radon-Is indoor radon the risk factor for lung cancer? Ann Occup Environ Med 2016; 28:9. [PMID: 26949535 PMCID: PMC4778293 DOI: 10.1186/s40557-016-0094-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 02/18/2016] [Indexed: 01/21/2023] Open
Abstract
Lung cancer is a leading cause of cancer-related death in the world. Smoking is definitely the most important risk factor for lung cancer. Radon (222Rn) is a natural gas produced from radium (226Ra) in the decay series of uranium (238U). Radon exposure is the second most common cause of lung cancer and the first risk factor for lung cancer in never-smokers. Case–control studies have provided epidemiological evidence of the causative relationship between indoor radon exposure and lung cancer. Twenty-four case–control study papers were found by our search strategy from the PubMed database. Among them, seven studies showed that indoor radon has a statistically significant association with lung cancer. The studies performed in radon-prone areas showed a more positive association between radon and lung cancer. Reviewed papers had inconsistent results on the dose–response relationship between indoor radon and lung cancer risk. Further refined case–control studies will be required to evaluate the relationship between radon and lung cancer. Sufficient study sample size, proper interview methods, valid and precise indoor radon measurement, wide range of indoor radon, and appropriate control of confounders such as smoking status should be considered in further case–control studies.
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Affiliation(s)
- Seungsoo Sheen
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Keu Sung Lee
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Wou Young Chung
- Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Saeil Nam
- Department of Humanities and Social Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Dae Ryong Kang
- Department of Humanities and Social Medicine, Ajou University School of Medicine, Suwon, Republic of Korea
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31
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Kreuzer M, Fenske N, Schnelzer M, Walsh L. Lung cancer risk at low radon exposure rates in German uranium miners. Br J Cancer 2015; 113:1367-9. [PMID: 26393888 PMCID: PMC4815799 DOI: 10.1038/bjc.2015.324] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 07/22/2015] [Accepted: 08/14/2015] [Indexed: 11/09/2022] Open
Abstract
Background: A determination of the risk of lung cancer at low levels of radon exposure is important for occupational radiation protection. Methods: The risk of death from lung cancer at low radon exposure rates was investigated in the subcohort of 26 766 German uranium miners hired in 1960 or later. Results: A clear association between lung cancer mortality (n=334 deaths) and cumulative exposure to radon in working level months (WLM) was found. The excess relative risk per WLM was 0.013 (95% confidence intervals: 0.007; 0.021). Conclusions: The present findings provide strong evidence for an increased lung cancer risk after long-term exposure to low radon exposure rates among Wismut miners. The results are compatible to those from residential radon studies and miner studies restricted to low levels.
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Affiliation(s)
- M Kreuzer
- Department of Radiation Protection and Health, Federal Office for Radiation Protection, Neuherberg, Germany
| | - N Fenske
- Department of Radiation Protection and Health, Federal Office for Radiation Protection, Neuherberg, Germany
| | - M Schnelzer
- Department of Radiation Protection and Health, Federal Office for Radiation Protection, Neuherberg, Germany
| | - L Walsh
- Department of Radiation Protection and Health, Federal Office for Radiation Protection, Neuherberg, Germany
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